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Organization
MISSISSIPPI HEALTH CENTER MEDICINAY LLC
Active
Organization
MISSISSIPPI HEALTH CENTER MEDICINAY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETH YOHALEM-ILSLEY L.AC. (CO-PRESIDENT)
(503) 267-1565
Entity
Organization
Contact information
Practice address
4631 N ALBINA AVE, PORTLAND, OR 97217-3011
(503) 282-5358
(503) 735-3777
Mailing address
4631 N ALBINA AVE, PORTLAND, OR 97217-3011
(503) 282-5358
(503) 735-3777
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
AC00668
OR
175F00000X
Naturopath
Primary
1400
OR
Other
Enumeration date
04/12/2007
Last updated
04/21/2008
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